STATE OF [insert state] (SS.: COUNTY OF [insert county] ] Before me, this [insert date] appeared in person: [name of the appointor], to me, as you know, the person described in and who performed the above attribution instrument, and confirmed to me that [she] had performed the same thing of [her] free will for the object expressed therein. __________ Excerpt from copyright Permission and Libel Handbook: A Step-by-Step Guide for Writers, Editors and Publishers (John Wiley & Sons) IMPORTANT NOTE: This form may only be used under the supervision of a qualified professional. This form does not constitute legal assistance. It is your responsibility to ensure the accuracy of this form and compliance with local laws. This document allows the parties to fill in the details of the work to be transferred or works to be transferred and to ensure that everything necessary for registration in the United States is present. Each party – either the person transferring the copyright or the person receiving the copyright – can fill out this form. Please note that this form requires both signatures and a certified notary. Pres., Old New Locomp Co.) Date: __________ B_ Copyright attributions are most frequently used in situations where copyright is already registered with the United States Copyright Office, and it is preferable for both parties to have a registration of the assignment. Often, copyright assignments are used when the rights to a work are given, so the party that obtains the rights can use that work for any desired purpose. . . .